“Epidemic” Teen Vaping Based Only on NYTS, FDA-Funded PATH Survey Ignored

 

Teen vaping estimates from the CDC and other anti-tobacco crusaders are hyperinflated by the National Youth Tobacco Survey (NYTS).  As I have shown previously, the CDC routinely ignores the federal government’s premier tobacco survey, the Population Assessment of Tobacco and Health (PATH), which supports far lower vaping figures. 

The chart at left, which includes the latest comparison from 2017, is crystal clear. It shows only underage high schoolers (age 15-17 years), since until recently tobacco products were legal for those 18 or older.  Based on the 2017 NYTS, 11.8% of those youths used an e-cigarette in the past 30 days; that contrasts with the 7.3% estimate from PATH.  The NYTS percentage translates to 1.35 million underage vapers; the PATH number is half a million fewer, at 832,000.

There is no legitimate reason for federal officials to ignore PATH, which was purposefully designed, implemented and funded by the FDA to inform federal tobacco regulation.  PATH should be the logical choice of all researchers, and, in fact, it has over the past five years appeared in twice as many PubMed articles as has NYTS.

For over a decade, I have noted how government agencies cherry pick their sources for smoking statistics.  Sometimes, when they want to emphasize lower smoking rates among adults, they choose a source (NHIS) that undercounts smokers by 9 or 10 million.  This time, the government is straining to sustain the “teen vaping epidemic” narrative in order to justify prohibitive policies.

Four years of comparison is important, but the real test will come when PATH releases the fifth wave of its youth survey – for the year 2018, when the NYTS was the basis for the government’s dire warning, in the words of former FDA chief Scott Gottlieb, that “e-cigarette use…threatens to hook an entire generation of kids into a lifetime of addiction.”  It is likely that PATH will show a modest increase, but not enough to support such a dramatic claim.  Stay tuned. 

 

A Smokeless Tobacco-Pancreatic Cancer Claim is Refuted

Snus use is not associated with pancreatic cancer, according to a study published in the International Journal of Cancer (abstract here).  Researchers combined data from nine cohort studies that involved 400,000 men in Sweden.  Compared with never users, the risk for current snus users, after adjustment for smoking, was 0.96 (95% confidence interval = 0.83 – 1.11).

The new work was conducted by the Swedish Collaboration on Health Effects of Snus Use, which includes researchers from several Swedish universities.  (In the past, snus research was largely performed by the Karolinska Institute, whose flawed studies I have previously documented here, here, here, and here.)  Their results are almost identical to those in a large study of smokeless use in North America and Europe published six years ago (discussed here), and to findings in another analysis published eight years ago (here).

Focus on a purported smokeless tobacco-pancreatic cancer link began after publication of a cherry-picked meta-analysis by Paolo Boffetta in 2008 (discussed here).  Dr. Boffetta contradicted his own finding in a later study (here), and epidemiologist Peter Lee refuted it in his comprehensive analysis in 2009 (here).  The fact is that there is no credible evidence that American or Swedish smokeless tobacco is linked to pancreatic cancer.      

Remarkably, the National Cancer Institute persists in asserting a pancreatic cancer link in its smokeless tobacco “fact sheet” (here).  That document also asks what should be a rhetorical question: “Is using smokeless tobacco less hazardous than smoking cigarettes?” 

The NCI’s answer is grossly misleading: “all tobacco products are harmful and cause cancer…There is no safe level of tobacco use.”  The agency’s source for this obfuscation is a 31-year-old Surgeon General report that has been eclipsed by three decades of epidemiologic studies.  

It should be noted that the U.S. Food & Drug Administration is equally culpable. That agency used the bogus smokeless-pancreatic cancer link as a talking point in last year’s $36 million campaign against smokeless tobacco (here).

We already knew that moist snuff and chewing tobacco have no measurable risk for mouth cancer (here).  Now there is scientific evidence that smokeless isn’t linked to pancreatic cancer.   

The Truth Initiative Belies Its Name in New Smokeless Tobacco Screed

The Truth Initiative is a billion-dollar foundation devoted to tobacco prohibition.  Launched as the American Legacy Foundation with cash from the 1998 Master Settlement Agreement (here), the group changed its name in 2015.  The Initiative recently issued a “fact sheet” on smokeless tobacco that is grossly inaccurate and misleading.

On one hand, it suggests that smokeless is safer: “Switching completely from smoking cigarettes to using the least harmful forms of smokeless tobacco (e.g., Swedish snus) may result in lower health risks to individuals,”…cancer risks are “lower for smokeless tobacco users than for smokers,” and “…smokeless tobacco use, while harmful, is less harmful than cigarette smoking.  The least harmful smokeless tobacco products are low-nitrosamine Swedish snus…”

The last statement is blantantly wrong.  As I explained in a recent post (here), it is impossible to differentiate risks among Swedish and American smokeless products.  There is no basis for the claim that “Harms from smokeless tobacco products vary by product type.”  

The Initiative departs from mainstream science with an additional assertion: “Smokeless tobacco use causes precancerous oral lesions, oral, esophageal, and pancreatic cancer.”  Their source for that hyperbolic statement is the same as a recent FDA campaign: embarrassingly weak and misleading information from Paolo Boffetta and colleagues at the International Agency for Research on Cancer, debunked here.  While actual risk estimates for these diseases would leave the media and consumers totally unimpressed, the Initiative omits them all, much as other anti-tobacco agencies routinely do.

Imprecision, hyperbole and cherrypicked data are the hallmarks of the well-funded and often taxpayer-supported tobacco prohibition movement.  In the absence of truth and transparency, public health only suffers.